Abstract:
Stroke is one of the most common illnesses in life, and a significant percentage is associated with cognitive impairments greatly affecting the course of geriatric rehabilitation procedures. Among other things, attention and memory factors are related to functional independence and the dismissal into a premorbid state. While the effectiveness of cognitive rehabilitation can be assumed, prospective control group surveys focusing specifically on the requirements of geriatric rehabilitation facilities are currently not yet available. Moreover, research studies addressing the effect of neuropsychological intervention strategies on the functional outcome of patients are still lacking. The Clinic of Geriatric Rehabilitation at the Robert-Bosch-Krankenhaus conducted a study into general cognitive performance levels, attention and memory functions, as well as mobility and independence of 133 apoplexy patients. The attention performance was recorded on the basis of cognitive processing speed, alertness and stimulus selection. The memory test entailed both verbal and figural tests for the assessment of the short-term retention performance and longer-term recognition ability. Simultaneously, activities of daily living, movement quality and walking speed were surveyed. The aim of the randomized control group study was the evaluation of a computer-aided cognitive training (“RehaCom”) that was to be compared with the standard treatments in geriatric rehabilitation. It was anticipated that the nine-hour intervention would change the patients’ attention and memory performance, and that this change would not only be noted after the completion of the rehabilitation, but would still be perceivable three months later. This development was expected to have a positive influence on the patients’ acquisition of independence and mobility. Participation in the computer training had a lesser effect on the cognitive impairments than anticipated. It could be observed, however, that the treated patients enjoyed improved nonverbal memory performance. While an equal improvement of the functional variables in both the experimental and the control group could be observed in the course of rehabilitation, the patients who had received cognitive rehabilitation treatment – unlike the persons in the control group – were able to expand their mobility and independence until the scheduled follow-up examination three months later. The discussion currently centers on whether the advantage in the disabilities as a function of an increase in "self-efficacy" can be explained as a moderator variable.